How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,072 to $12,882Professionalmedian $1,148 · 10th to 90th $724 to $1,820
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $4,570.88 Median $7,943.28 Typical High $13,489.63 | Facility | None | $4,570.88 | $7,943.28 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,513.56 | Professional | None | $741.31 | $954.99 | $1,513.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,621.81 Median $5,248.07 Typical High $15,488.17 | Facility | None | $1,621.81 | $5,248.07 | $15,488.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $1,548.82 | Professional | None | $831.76 | $1,122.02 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,659.59 Typical High $2,344.23 | Professional | 50 · Both sides | $1,230.27 | $1,659.59 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $707.95 Typical High $977.24 | Professional | 62 · Two surgeons | $512.86 | $707.95 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $177.83 Typical High $245.47 | Professional | 80 · Assistant surgeon | $131.83 | $177.83 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $154.88 Typical High $218.78 | Professional | AS · PA/NP assist | $114.82 | $154.88 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $9,772.37 Typical High $12,022.64 | Facility | None | $1,000.00 | $9,772.37 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,995.26 | Professional | None | $977.24 | $1,148.15 | $1,995.26 |
ConnectiCare Setting Facility Modifier None Typical Low $1,000.00 Median $5,248.07 Typical High $5,370.32 | Facility | None | $1,000.00 | $5,248.07 | $5,370.32 |
ConnectiCare Setting Professional Modifier None Typical Low $1,202.26 Median $1,288.25 Typical High $2,398.83 | Professional | None | $1,202.26 | $1,288.25 | $2,398.83 |
Health New England Setting Facility Modifier None Typical Low $7,413.10 Median $11,481.54 Typical High $18,197.01 | Facility | None | $7,413.10 | $11,481.54 | $18,197.01 |
Health New England Setting Professional Modifier None Typical Low $199.53 Median $1,380.38 Typical High $1,513.56 | Professional | None | $199.53 | $1,380.38 | $1,513.56 |
United Setting Facility Modifier None Typical Low $870.96 Median $5,495.41 Typical High $10,471.29 | Facility | None | $870.96 | $5,495.41 | $10,471.29 |
United Setting Professional Modifier None Typical Low $524.81 Median $1,096.48 Typical High $2,691.53 | Professional | None | $524.81 | $1,096.48 | $2,691.53 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $426.58 Median $446.68 Typical High $758.58 | Professional | 52 · Reduced service | $426.58 | $446.68 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $177.83 Typical High $302.00 | Professional | 53 · Discontinued | $173.78 | $177.83 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $660.69 Typical High $1,148.15 | Professional | 54 · Surgery only | $645.65 | $660.69 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $134.90 Typical High $229.09 | Professional | 55 · Aftercare only | $128.82 | $134.90 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $89.13 Typical High $151.36 | Professional | 56 · Pre-op care only | $87.10 | $89.13 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $616.60 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $602.56 | $616.60 | $1,071.52 |
Where Connecticut sits
The same service costs 5.1 times more in Alaska than in West Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
AK $10,217WV $2,002
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.